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REFRESHER CLASS

Registration & Agreement

PLEASE READ CAREFULLY AS YOU WILL BE BOUND TO THIS AGREEMENT.

Course Agreement

  1. I will attend the required 1 pool session of the Open Water SCUBA course costing $119 on the date agreed to with Scuba Network staff.
    I Agree
  2. The following equipment is necessary: scuba quality mask, snorkel, fins, booties, slate, whistle and log book. These items must be purchased or rented. All other major equipment will be provided during the course.
    I Agree
  3.  The instructor, at their discretion, must make final judgment as to my competency to be a safe diver and sign off on my logbook or if additional sessions are required. 
    I Agree
  4. I understand that there is a $60 registration deposit included in the cost of this course. I also understand that if I cancel for any reason in less than 7 days before the first session, this registration deposit is non-refundable; after the pool session, none of the course is refundable. I understand that if I do not show up to my pool session at the agreed time, that I forfeit the entire class fee. 
    I Agree
  5. For your safety and ours, Scuba Network reserves the right to inspect all equipment you will be using in the pool or during open water dives PRIOR to starting any classes. At the sole discretion of Scuba Network, any equipment deemed unsatisfactory or unfamiliar will not be allowed to be used. I understand that by not having equipment checked prior to the class sessions I may be turned away and be required to remake the session at an additional fee. 
    I Agree

I have read this agreement. I understand it. I agree to be bound by it. 

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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